Kemp Andrew S
Department of Allergy and Immunology, The Children's Hospital at Westmead, Sydney, Australia.
Pediatr Allergy Immunol. 2007 Dec;18(8):696-702. doi: 10.1111/j.1399-3038.2007.00679.x.
Egg allergy is one of the most common food allergies in infants and young children. The great majority is not life-threatening and management involves exclusion of egg from the diet and regular review with the expectation that the majority of children will outgrow the allergy by school age. Judgment is required as to when the dietary elimination of egg is no longer required. This decision may be helped by demonstrating loss of sensitivity by skin prick or specific IgE testing and in some cases a supervised food challenge. Particular issues in management arise with more severe, potentially life-threatening reactions, with immunization with vaccines prepared in eggs, with the diagnosis of egg hypersensitivity as a cause of delayed exacerbations of eczema which can be non-IgE mediated, and in deciding whether a child can be allowed to ingest small amounts of cooked egg through egg-containing foods while continuing to avoid raw egg or larger amounts of whole egg. Cases which illustrate these issues are presented.
鸡蛋过敏是婴幼儿最常见的食物过敏之一。绝大多数情况并不危及生命,管理措施包括从饮食中排除鸡蛋,并定期复查,因为大多数儿童到学龄期会不再对鸡蛋过敏。需要判断何时不再需要从饮食中排除鸡蛋。通过皮肤点刺试验或特异性IgE检测显示敏感性消失,以及在某些情况下进行有监督的食物激发试验,可能有助于做出这一决定。在管理方面,对于更严重、可能危及生命的反应、用鸡蛋制备的疫苗进行免疫接种、将鸡蛋超敏反应诊断为湿疹延迟加重的原因(这可能是非IgE介导的)以及决定儿童在继续避免生鸡蛋或大量全蛋的同时是否可以通过含鸡蛋的食物摄入少量熟鸡蛋等问题,会出现一些特殊情况。文中展示了说明这些问题的病例。